Sjogren’s syndrome is an autoimmune disorder that affects the moisture-producing glands in the body. One of the most common symptoms of Sjogren’s is joint pain and stiffness, particularly in the hands, wrists, knees, and ankles.
What causes the joint pain in Sjogren’s syndrome?
The joint pain associated with Sjogren’s is caused by inflammation in the joints and surrounding tissues. This inflammation is triggered by the immune system mistakenly attacking the body’s own cells and tissues. Some of the key factors that contribute to joint pain in Sjogren’s include:
- Inflammation of the joints (arthritis)
- Inflammation of the tendons, ligaments and bursae
- Inflammation of the nerves
- Fatigue and muscle pain
- Dryness of the joints
What does Sjogren’s joint pain feel like?
People with Sjogren’s often describe the joint pain as a pronounced aching, throbbing, or soreness in the affected joints. Here is how Sjogren’s joint pain can feel in different parts of the body:
Hand and wrist pain
- Deep aching pain in the knuckles, fingers, and wrists
- Stiffness and reduced range of motion in the hands and wrists, especially in the morning
- Pain or difficulty with gripping, grasping, making a fist, or performing fine hand movements
- Tender, swollen joints in the hands and wrists
- Tingling or numbness in the hands due to inflammation of the nerves (carpal tunnel syndrome)
Knee pain
- Deep, throbbing pain in one or both knees
- Stiffness and pain when walking, bending, kneeling, or going up and down stairs
- Feeling like the knees may “give out” or buckle
- Swelling, warmth and redness around the knees
- Creaking or crunching sounds when moving the knees
Ankle and foot pain
- Stabbing or burning pain in the heels, balls of the feet, and toes
- Joint swelling, redness and warmth in the ankles and feet
- Stiffness in the joints, especially in the morning
- Reduced range of motion, making walking difficult
- Tingling or numbness in the feet
Elbow, shoulder and neck pain
- Deep, nagging pain in the elbows, shoulders and neck
- Muscle tenderness and tightness around the neck and shoulders
- Stiffness and reduced range of motion in the elbows and shoulders
- Aching, throbbing pain that worsens with movement
- Difficulty lifting the arms overhead or behind the back
What makes Sjogren’s joint pain worse?
While Sjogren’s joint pain can be quite persistent, patients often report worsening pain and stiffness related to certain triggers, including:
- Overuse of the joints with activities
- Cold, damp weather
- Prolonged periods of inactivity, such as sitting or lying down
- Joint stress from lifting, bending, or squatting repeatedly
- Fatigue and lack of sleep
- Hormonal fluctuations related to women’s menstrual cycles
- Emotional stress
Does the pain come and go?
For many Sjogren’s patients, the joint pain tends to come and go in flares. The pain may arise suddenly, last for hours to days at a time, and then subside before flaring back up again. Many people with Sjogren’s notice their joint pain flares:
- When first getting out of bed in the morning
- After staying in one position too long, such as sitting at a desk or lying on a sofa
- With overuse of the joints after activities or exercise
- When exposed to cold temperatures
- During times of hormonal changes or stress
While the pain may ease up at times, some degree of persistent discomfort in the joints is common. Pain levels can fluctuate daily and week-to-week.
What joints are most often affected?
The small joints of the hands, wrists, knees, ankles, feet, and neck are most commonly affected by Sjogren’s joint pain. However, any joint can be impacted. This table summarizes the joints most often involved:
| Joint | Percentage of Sjogren’s Patients Affected |
|---|---|
| Hands and wrists | 70-80% |
| Knees | 40-45% |
| Ankles and feet | 25-30% |
| Neck | 20-25% |
| Shoulders | 15-20% |
| Hips | 10-15% |
| Elbows | 10-15% |
How is Sjogren’s joint pain diagnosed?
To diagnose Sjogren’s joint pain, doctors will typically:
- Take a full medical history, asking about symptoms and when they occur
- Conduct a physical exam of all the joints, checking for swelling, redness and range of motion
- Order blood tests to look for inflammatory markers and autoantibodies related to Sjogren’s
- Analyze fluid from the joints to check for inflammation
- Perform imaging tests such as X-rays, ultrasound or MRI scans to look for damage
They may also perform a lip biopsy to confirm a diagnosis of Sjogren’s syndrome. Doctors need to rule out other types of arthritis and joint disorders that could be causing the pain as well.
How is Sjogren’s joint pain treated?
While there is no cure for Sjogren’s itself, the joint pain can be managed with medications and lifestyle approaches, including:
- Moisturizing eye drops – Can help with dry, irritated eyes
- NSAIDs – Non-steroidal anti-inflammatory drugs like ibuprofen to reduce swelling and pain
- DMARDs – Disease-modifying anti-rheumatic drugs like hydroxychloroquine and methotrexate to suppress the overactive immune system
- Corticosteroids – Can be injected into severely inflamed joints or taken orally during flares
- Low-impact exercise – Such as walking, stretching, water aerobics to improve strength and range of motion
- Heat and cold therapy – Applying heating pads or ice packs to painful joints
- Assistive devices – Splints, braces, shoe inserts to provide extra joint support
Doctors may also recommend surgery in some cases to repair joint damage or fuse badly damaged finger and toe joints.
What is the outlook for Sjogren’s joint pain?
With proper management, many patients find their Sjogren’s joint symptoms improve over time. However, joint problems can have a significant impact on quality of life. Working closely with your rheumatologist to find an effective treatment plan is key.
While living with chronic joint pain can be challenging, there are ways to adapt activities, pace yourself, and set up your environment to reduce discomfort and prevent further joint damage. Support groups can also help Sjogren’s patients share coping strategies.
The takeaway
Joint pain is one of the most common and debilitating symptoms of Sjogren’s syndrome. The pain often arises from inflammation in the joints and surrounding tissues. It is frequently described as an aching, throbbing, or soreness that waxes and wanes in severity. The hands, knees, ankles, and neck are most often affected. While treatment cannot cure Sjogren’s itself, many options are available to help relieve joint symptoms and improve quality of life.